A review of preoperative manoeuvres for prophylaxis of endophthalmitis in intraocular surgery

Grzybowski, Andrzej; Kuklo, Patrycja; Pieczyński, Janusz; Beiko, George

doi:10.1097/icu.0000000000000216

Cited by 33 publications

(18 citation statements)

References 57 publications

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“…A second area where a large-scale change in practice may be possible is the use of topical antibiotics prior to cataract surgery. A recent review of the literature concluded that, despite the widespread practice, the evidence supporting preoperative topical antibiotics is not compelling [59]. Finally, antibiotics are often misused in the treatment of viral and allergic conjunctivitis [58].…”

Section: Resistance Levels In Trust and Armor Studiesmentioning

confidence: 99%

Microbial flora and resistance in ophthalmology: a review

Grzybowski

Brona²,

Kim

2017

Graefes Arch Clin Exp Ophthalmol

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Antibiotic resistance in systemic infection is well-researched and well-publicized. Much less information is available on the resistance of normal ocular microbiome and that of ophthalmic infections. An understanding of the distribution of ocular microorganisms may help us in tailoring our empiric treatment, as well as in choosing effective pre-, peri- and postoperative management, to achieve the best results for patients. This study aims to summarize and review the available literature on the subject of normal ocular flora and its resistance, as well as the broader topic of antibiotic resistance in ophthalmology.

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Section: Resistance Levels In Trust and Armor Studiesmentioning

confidence: 99%

Microbial flora and resistance in ophthalmology: a review

Grzybowski

Brona²,

Kim

2017

Graefes Arch Clin Exp Ophthalmol

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“…58 Despite the widespread practice, the evidence supporting preoperative topical antibiotics is not compelling. 59 Antibiotic prophylaxis in intravitreal injection (IVI) and cataract surgery might be questioned by this aspect. 60 One such alternative already employed in ophthalmology is the use of effective antiseptics such as povidone iodine and chlorhexidine instead of antibiotics.…”

Section: Use Of Antibiotics When Proved To Be Tangible Benefitmentioning

confidence: 99%

<p>Treatment-Resistant Bacterial Keratitis: Challenges and Solutions</p>

Eğrilmez¹,

Yildirim-Theveny²

2020

OPTH

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Bacterial keratitis is an important ophthalmic emergency and one of the most common causes of corneal blindness. The main causes of treatment resistance in bacterial keratitis are failure to eliminate predisposing factors, misdiagnosis and mistreatment. At first, exogenous, local and systemic predisposing factors that disturbing ocular surface must be eliminated to improve corneal ulcers and to prevent recurrences. Smears and scrapings for staining and culture are indispensable diagnostic tools for cases of sight-threatening keratitis (centrally located, multifocal, characterized by melting, painful). Main treatment agents in bacterial keratitis treatment are topical antibiotics. Until the results of culture antibiograms reach the ophthalmologist, empirical antibiotic selections based on direct microscopic examination and gram stain findings are the most appropriate initial treatment approach currently. S. aureus and coagulase-negative staphylococci (CoNS), the most common gram-positive agents, have resistance rates of more than 30% for fluoroquinolone and methicillin. Multidrug resistance rates are similarly high in these microorganisms. P. aeruginosa is the most common gram-negative micro-organism, in case of multidrug-resistant isolates, both functional and anatomical prognosis of the eyes are very poor. In cases of sight-threatening and resistant keratitis, antibiotic susceptibility testing containing imipenem, colistin, and linezolid is seeming to be an important requirement. Despite its efficiency limited to superficial cases, a nonpharmaceutical anti-infective treatment option such as corneal crosslinking for bacterial keratitis is an emerging hope, while antibiotic resistance increases.

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“…In addition to the use of anti-infectives in the setting of active infection, the eyes innate defense mechanisms are perturbed during ocular surgeries, where bacteria and other agents may be allowed to enter the eye. Therefore, a very common use of anti-infective therapy is prophylaxis perioperatively (Grzybowski et al 2016). While this chapter will discuss, at least in brief, a number of anti-infective therapies, the chapter will also serve to highlight some of the principles behind the use of anti-infective therapies both in the treatment of active infection and prophylaxis.…”

Section: Introductionmentioning

confidence: 99%

Anti-Infective and Anti-Inflammatory Pharmacotherapies

Rosenblatt

2017

Handbook of Experimental Pharmacology

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Ocular infection and inflammation are common and are associated with myriad ocular conditions ranging from mild disease to blinding conditions. There are numerous anti-invectives with spectra against inciting pathogens. Given the potential for ocular infections to rapidly progress initial broad spectrum therapy is usually required, with therapy tailored as microbiological identification and sensitivities become available. The emergence of antibiotic resistance has become a major health problem. Anti-inflammatory therapy can be institutes to prevent ocular symptoms and end-organ damage. A therapy should be selected which is potent enough to interrupt the inflammatory cascades in play, but which avoids potential side effects. Glucocorticoids, NSAIDs, and biological agents may be used singularly or in combination. New drug delivery devices may allow for better local treatment of chronic ocular inflammation.

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A review of preoperative manoeuvres for prophylaxis of endophthalmitis in intraocular surgery

Abstract: There is strong evidence for the use of povidone-iodine preoperatively for prophylaxis of postoperative endophthalmitis in ocular surgery; the evidence for topical antibiotics is not as compelling.

Cited by 33 publications

References 57 publications

Microbial flora and resistance in ophthalmology: a review

Microbial flora and resistance in ophthalmology: a review

<p>Treatment-Resistant Bacterial Keratitis: Challenges and Solutions</p>

Anti-Infective and Anti-Inflammatory Pharmacotherapies

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